Provider Demographics
NPI:1124471271
Name:NGUYEN, JENIFER (OD)
Entity type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JENIFER
Other - Middle Name:
Other - Last Name:NGUYEN SHINPAUGH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2727 MAIN ST STE 620
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75036-4319
Mailing Address - Country:US
Mailing Address - Phone:469-699-8599
Mailing Address - Fax:469-699-8549
Practice Address - Street 1:2727 MAIN ST STE 620
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75036-4319
Practice Address - Country:US
Practice Address - Phone:469-699-8599
Practice Address - Fax:469-699-8549
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8983T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist